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Ankle arthrodesis is an effective surgical intervention for end-stage arthritis or severe ankle joint deformity. Both internal (IF) and external fixation (EF) techniques are valid options, but there is controversy regarding the most effective technique. This study compares the safety and efficacy of EF and IF fixation techniques for ankle arthrodesis. A systematic review and meta-analysis was conducted according to the Preferred reporting items for systematic reviews and meta-analyses (PRISMA) Guidelines. A literature search of electronic databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL), was performed to identify all studies directly comparing the two techniques. Both fixed and random effects models of analysis were used depending on heterogeneity. Odds of union in the EF and IF groups were comparable (OR = 0.60, CI 0.36-1.02, p =.06) however, EF was associated with greater odds of deep hardware infections (OR = 3.67, 1.97-6.83, p <.05) and amputations (OR = 3.17, CI 1.06-9.54, p =.04). Odds of revision surgery and superficial wound complications were similar between groups. EF techniques had significantly longer operation times (MD = 31.23, CI-25.11-37.34, p <.05) and intraoperative blood loss (MD = 44.1, CI 28.77-59.43, p <.05). No significant difference was noted in pain and functionality scores. IF and EF techniques have reasonable union rates with similar postoperative outcomes. [ABSTRACT FROM AUTHOR]

Epiphora is an annoying symptom, embarrassing the patient both socially and functionally. The two widely accepted treatment modalities of epiphora resulting from obstruction of the nasolacrimal ductus are external and endoscopic dacryocystorhinostomy (DCR). To compare the outcome of endonasal endoscopic dacryocystorhinostomy with stent and without stent prospectively and to compare the outcome of endonasal endoscopic dacryocystorhinostomy with stent and without stent with external dacryocystorhinostomy retrospectively. This retrospective and prospective clinical interventional study was done in the Department of Otorhinolaryngology and Institute of Ophthalmology, Jawaharlal Nehru Medical College, A.M.U., Aligarh from July 2012 to September 2017. 110 patients of epiphora participated in the study and were divided into three groups: Group I: Endoscopic endonasal dacryocystorhinostomy with stent. Group II: Endoscopic endonasal dacryocystorhinostomy without stent. Group III: External dacryocystorhinostomy. Out of them 60 patients were for Endoscopic dacryocystorhinostomy (30 patients with stent and 30 patients without stent) and 50 patients were for External dacryocystorhinostomy. 71 (65%) were females while 39 (35%) were males (p < 0.05) with age ranging from ranging 8–60 years (mean 34.96 years) with predominance of symptoms in left eye (p < 0.01). A lower complication rate was observed in the endoscopic group, with minimal morbidity and shorter operative time compared with the external approach. Follow up was done at postoperative day 1st and 7th, at 2 weeks, 4 weeks and 3 months for assessing complications of operation, symptomatic relief of epiphora and syringing for anatomical patency. In our study, Success rate was 93.30% in Group I and 96.60% in Group II while 90% in group III. The avoidance of a cutaneous scar has been a strong impetus to further the success and improve outcomes of endonasal DCR. Endonasal DCR without stent has lesser incidence of post-operative fibrosis and higher patient's acceptance. [ABSTRACT FROM AUTHOR]

Background: Road traffic injuries are the major health problems and leading cause of death and injury around the world. This study was conducted in order to observe the pattern of external injuries and internal injuries. In many set ups there may not be adequate facilities for investigations like imaging. If it is possible to know the common patterns in external and internal injuries it would be possible to give appropriate care and prioritise the treatment. Methods: An autopsy based prospective study was conducted during the period 2011 to 2013 in the Department of Forensic Medicine after obtaining ethical clearance The pattern of external and visceral injuries in cases of motorised two wheeler accidents were observed and documented. Conclusion: Out of 37 cases examined at autopsy Among external injuries Abrasions are commonly seen involving the whole body. Among Visceral injuries Contusions are seen more in Lungs followed by Kidney Spleen, Heart and Liver.Among laceration Liver has the most followed by lung and Spleen. [ABSTRACT FROM AUTHOR]

Given the posterior chain configuration, it is anticipated that tibial positioning influences hamstring recruitment; medial hamstrings should be more activated during medial rotation, while lateral hamstrings should be more activated during lateral rotation. However, most studies showing this pattern have focused on concentric or isometric strength, leaving the influence on eccentric strength fairly unknown. Therefore, the aim of this study was to investigate the electromyographic response of the hamstring muscles during Nordic hamstring exercises in three leg positions: internal rotation, external rotation, and neutral. This study encompassed a randomized crossover study and used surface electromyography to analyze the activity of the biceps femoris and semitendinosus muscles during the Nordic hamstring exercise, in the three positions. Results indicated no statistically significant differences in muscle activation between positions or sides (p > 0.05), though small effect sizes were observed for the biceps femoris in different positions (η2 = 0.01–0.03). Furthermore, the internal rotation position generally elicited the highest muscle activations. Notably, biceps femoris muscles exhibited higher activations compared to semitendinosus muscles, with the greatest differences seen in the internal rotation position. This suggests that tibial rotation influences hamstring recruitment patterns; however, it was lower than expected. [ABSTRACT FROM AUTHOR]

The capital market has increasingly become a pivotal avenue for enterprises seeking additional capital for expansion or operational enhancements. In raising funds through an Initial Public Offering (IPO), the company must publish its risk disclosure in the prospectus. Therefore, this study aims to investigate the impact of risk disclosure on the initial return of Indonesian companies undergoing IPOs during the pandemic. Using data from 136 out of 164 companies that went public between 2020 and 2022, sourced from the Indonesian Stock Exchange and company websites, the study employs the ordinary least squares method to estimate the impact of risk disclosures on initial returns during the pandemic. The findings reveal that external and overall risk disclosures significantly influence IPO initial returns. Specifically, Indonesian investors were particularly attentive to external and overall risks when evaluating IPOs during the pandemic. This heightened concern suggests that comprehensive risk disclosure can affect investor behavior and financial outcomes for companies going public in uncertain times, highlighting the importance of transparency in risk communication to support investor decision-making and market stability.

This article explores the nonlinear dynamical analysis and control of a 2 − DOF system that emulates the lateral vibration of an asymmetric rotor model under external, multi-parametric, and mixed excitation. The linear integral resonant controller (L I R C) has been coupled to the rotor as an active damper through a magnetic actuator. The complete mathematical model, governing the nonlinear interaction among the rotor, controller, and actuator, is derived based on electromagnetic theory and the principle of solid mechanics. This results in a discontinuous 2 − DOF system coupled with two 1 / 2 − DOF systems, incorporating the rub-impact effect between the rotor and stator. The complicated mathematical model is investigated using analytical techniques, employing the perturbation method, and validated numerically through time response, basins of attraction, bifurcation diagrams, 0 − 1 chaotic test, and Poincaré return map. The main findings indicate that the asymmetric system model may exhibit nonzero bistable forward whirling motion under external excitation. Additionally, it can whirl either forward or backward under multi-parametric excitation, besides the trivial stable solution. Furthermore, in the case of mixed excitation, the rotor displays nontrivial tristable solutions, with two corresponding to forward whirling orbits and the other one corresponding to backward whirling oscillation. These findings are validated through the establishment of different basins of attraction. Finally, the performance of the L I R C in mitigating rotor vibrations and averting nonlinear catastrophic bifurcations under various excitation conditions. Furthermore, the rotor's dynamical behavior and stability are explored in the event of an abrupt failure of one of the connected controllers. The outcomes demonstrate that the proposed L I R C effectively eliminates dangerous nonlinearities, steering the system to respond akin to a linear system with controllable oscillation amplitudes. However, the sudden controller failure induces a local rub-impact effect, leading to a nonlocal quasiperiodic oscillation and restoring the dominance of the nonlinearities on the system's response. [ABSTRACT FROM AUTHOR]

Given the posterior chain configuration, it is anticipated that tibial positioning influences hamstring recruitment; medial hamstrings should be more activated during medial rotation, while lateral hamstrings should be more activated during lateral rotation. However, most studies showing this pattern have focused on concentric or isometric strength, leaving the influence on eccentric strength fairly unknown. Therefore, the aim of this study was to investigate the electromyographic response of the hamstring muscles during Nordic hamstring exercises in three leg positions: internal rotation, external rotation, and neutral. This study encompassed a randomized crossover study and used surface electromyography to analyze the activity of the biceps femoris and semitendinosus muscles during the Nordic hamstring exercise, in the three positions. Results indicated no statistically significant differences in muscle activation between positions or sides (p > 0.05), though small effect sizes were observed for the biceps femoris in different positions (η2 = 0.01–0.03). Furthermore, the internal rotation position generally elicited the highest muscle activations. Notably, biceps femoris muscles exhibited higher activations compared to semitendinosus muscles, with the greatest differences seen in the internal rotation position. This suggests that tibial rotation influences hamstring recruitment patterns; however, it was lower than expected.

Le cancer de la prostate est le plus fréquent chez l'homme et, au stade localisé, les schémas d'hypofractionnement de la radiothérapie sont devenus des standards, mais l'absence de risque aggravé de toxicité aiguë et tardive génito-urinaire et gastro-intestinale de l'escalade de dose reste à prouver. La population étudiée comprenait tous les patients pris en charge à l'institut Curie de février 2016 à mars 2018 pour un adénocarcinome prostatique localisé traité par irradiation externe délivrée par un accélérateur linéaire en technique conformationnelle avec modulation d'intensité guidée par l'image à la dose totale de 75 Gy en 30 fractions de 2,5 Gy dans le volume cible prévisionnel comprenant la prostate et les vésicules séminales proximales, et pouvait associer une radiothérapie prophylactique ganglionnaire de 46 Gy en 23 fractions avec la technique de boost intégré. En tout, 166 patients ont été inclus, dont 114 étaient atteints de cancer de risque au moins intermédiaire défavorable (soit 68,7 %). L'âge et le suivi médians étaient de 71,4 ans et 3,96 ans. Cent quarante-neuf patients ont reçu une radiothérapie ganglionnaire (soit 89,8 %). Cent trente et un patients ont reçu une hormonothérapie (soit 78,9 %). Une toxicité génito-urinaire de grade 2 ou plus a été notée en cours de radiothérapie, à 6 mois, 1 an et 5 ans respectivement dans 36,7 %, 8,8 %, 3,1 % et 4,7 % des cas. Deux patients ont souffert à 5 ans d'une toxicité de grade 4 (soit 1,6 %). Une toxicité gastro-intestinale de grade 2 ou plus a été notée en cours de radiothérapie, à 6 mois, 1 an et 5 ans dans respectivement 15,1 %, 1,9 %, 14,6 % et 9,3 % des cas. Parmi ces derniers, huit patients ont souffert d'une toxicité de grade 3 (soit 6,2 %). Il n'y a eu aucune toxicité de grade 4. Les analyses n'ont pas mis en évidence de facteur prédictif de toxicité. Les taux de survie globale, sans progression et spécifique à 5 ans étaient respectivement de 82,4 %, 85,7 % et 93,3 %. La concentration sérique d'antigène spécifique de la prostate et les facteurs de risque cardiovasculaires ont été retrouvés comme facteurs prédictifs d'une dégradation de la survie globale (p = 0,0028 pour les deux). La radiothérapie externe pour un cancer prostatique localisé avec notre schéma modérément hypofractionné avec escalade de dose est bien tolérée. En l'absence de toxicité tardive majorée, l'analyse des modes de rechutes à long terme sera intéressante pour déterminer l'intérêt de cette escalade de dose sur les rechutes locales et à distance. Prostate cancer is the most frequent cancer among men and radiotherapy hypofractionation regimens have become standard treatments for the localized stages, but the absence of increased risk of acute and late genitourinary or gastrointestinal toxicity of the dose escalation still must be demonstrated. The study population included all patients with localized prostatic adenocarcinoma treated at the institut Curie from February 2016 to March 2018 by external radiation delivered by a linear accelerator using an image-guided conformal intensity modulation technique at a total dose of 75 Gy in 30 fractions of 2.5 Gy in the planning target volume that included the prostate and the proximal seminal vesicles, and could be paired with a prophylactic lymph node radiotherapy at 46 Gy in 23 fractions with simultaneous integrated boost. A total of 166 patients were included. Among them, 68.6% were unfavourable intermediate or (very) high risk. The median age and follow-up were 71.4 years and 3.96 years. One hundred and forty-nine patients received prophylactic lymph node radiotherapy (89.8%). One hundred and thirty-one patients received hormonotherapy (78.9%). Genito-urinary toxicity events of grades 2 or above during radiotherapy, at 6 months, 1 year and 5 years were respectively 36.7%, 8.8%, 3.1% and 4.7%. Two patients had late grade 4 toxicity at 5 years (1.6%). Grade 2 gastrointestinal toxicity events during radiotherapy, 6 months, 1 year and 5 years were respectively 15.1%, 1.9%, 14.6% and 9.3%. Of these, eight patients had grade 3 toxicity (6.2%). There was no grade 4 toxicity. Analyses did not reveal any predictive factor for toxicity. The 5-year overall, progression-free, and specific survival rates were respectively 82.4%, 85.7%, and 93.3%. Serum prostate specific antigen concentration and cardiovascular risk factors were found to be predictive factors of deterioration in overall survival (P = 0.0028 for both). External radiotherapy for localized prostatic cancer with our moderately hypofractionated dose escalation regimen is well tolerated. In the absence of increased late toxicity, the analysis of the modes of long-term relapses will be interesting to determine the benefit of this dose escalation on local and distant relapses. [ABSTRACT FROM AUTHOR]

Copyright of Magazine of Historical Studies & Archaeology is the property of Republic of Iraq Ministry of Higher Education & Scientific Research (MOHESR) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The objective of this study was to develop a practical staging method for reporting external carotid artery calcifications (ECACs) using cone-beam computed tomography (CBCT) imaging, specifically to standardize reporting for oral and maxillofacial radiologists. Methods: This retrospective study evaluated 489 CBCT scans for the presence of ECACs. Two calibrated evaluators assessed the scans in all three orthogonal planes, using the axial plane to develop the staging system. Calcifications were graded on a scale from 0 to 5. Results: ECACs were found in 170 out of 489 scans (34.7%). There was a statistically significant increase in ECAC distribution with age progression. The prevalence of ECACs was similar between genders. Grade 1 calcifications were most common in the 51–60 age group, Grade 2 in the 61–70 and 71–80 groups, and Grades 3 and 4 in the 81–90 group. No Grade 5 calcifications were observed in any age group. The inter-rater reliability showed an excellent correlation in the identification and grading of ECACs. Conclusions: The proposed grading system enables oral and maxillofacial radiologists to quantitatively report ECACs, facilitating timely referrals to physicians for further evaluation and early intervention, thereby potentially reducing the risk of cardiovascular events [ABSTRACT FROM AUTHOR]

This research uses the SWOT approach to review Murabaha financing at Baitul Maal Wat Tamwil (BMT). This research is field research, with primary and secondary data sources, such as questionnaires, interviews, and literature. The research sample consisted of 20 people and three informants. Data analysis uses a mixed method approach, quantitatively and qualitatively, with the IFAS, EFAS and SWOT matrices. The research results found that several internal and external factors need to be evaluated, such as public trust, quality leadership, networks and partnerships, excellent and friendly service, practical procedures, and strategic location, which are assets that organizations can utilize to socialize Murabaha financing in the community. Meanwhile, external opportunities such as support from government agencies, a majority Muslim community, and local marketing strategies offer further growth and development potential. However, there are areas for improvement in education and awareness, product and service innovation, limited resources, and local marketing strategies that need to be overcome. Furthermore, threats from many competitors, the same target market, and a low public understanding of Islamic financing exist. This research can be helpful as a reference for future research and then become a reference for BMT in aligning organizational strategy with internal strengths and external opportunities, as well as overcoming existing weaknesses and threats.

Importance: In a patient-centered field such as plastic surgery, patient-reported satisfaction can measure the success and value of surgery, since it is not uncommon for patient and surgeon assessments to differ. Currently, there is no standard for evaluating patient-reported satisfaction postauricular reconstruction. Objective: To systematically review the literature regarding patient-reported satisfaction postauricular reconstruction in microtia patients. Evidence Review: The databases MEDLINE, EMBASE, Cochrane, and Scopus were searched and preferred reporting items for systematic reviews and meta-analyses guidelines were followed. Studies documenting patient-reported satisfaction postauricular reconstruction in microtia patients were included. All techniques for ear reconstruction have been included in this review. Findings: Nineteen studies utilizing autologous reconstruction technique, comprising 3694 patients, met inclusion criteria. No standardized patient satisfaction assessment was used throughout the studies, indicating criteria variability to measure outcomes. Auricular substructure analysis highlighted lower patient satisfaction with the tragus and antitragus compared with the upper units. In addition, satisfaction depended on patient perception, not on a low surgical complication rate. Conclusions: There is a clear need to incorporate a standardized validated surgery-specific questionnaire related to patient satisfaction in the auricular reconstruction protocol.

Background: The surgical treatment of chronic limb-threatening ischemia and optimal conduit choice are extensively debated. The presence of suboptimal autologous material, such as varicosities or venous aneurysms, might impair long-term outcomes. Therefore, kink-resistant external supports have been advocated in the recent literature to improve the conduit quality and outcomes. This study analyzes the FRAME external support in venous ectasic grafts in patients with chronic limb-threatening ischemia. Methods: From September 2017 to September 2023, a total of sixteen patients underwent CLTI surgery with FRAME external support for venous grafts. The inclusion criteria for FRAME applications were varicose or ectasic autologous material with a diameter ≥ 4.5 and ≤ 8 mm in an isolated segment or in the entire vein and a higher risk of bypass extrinsic compression (e.g., extra-anatomical venous bypass course). Results: Technical success and intraoperative patency were achieved in all cases. At 30 days, the limb salvage and survival rates were 100%. The primary bypass patency was 93.7% due to an early graft occlusion. No graft infection was registered. In one case, dehiscence of the surgical wound was treated by surgical debridement and antibiotic therapy. Minor amputation was required in four patients. Over a median follow-up of 32 months, two occlusions were observed; one was treated with reoperation and the other with major amputation. The primary patency was 68.7% and the assisted primary patency was 75%. Limb salvage rates observed during the entire follow-up period were 87.5%. No graft infections or dilatation of the reinforced veins were registered. Conclusions: For patients with CLTI undergoing infrainguinal bypass, satisfactory results in terms of patency and limb salvage rates were achieved using the autologous venous material, even if ectasic or varicose, with the vascular external support FRAME. [ABSTRACT FROM AUTHOR]

Introduction and objective: The parapharyngeal space is a deep space of the head and neck of important anatomical difficulty. Although it is a region where only 0.5% of craniocervical tumors are located and most of these are benign, it presents a large number of neurovascular structures essential for the patient's life, and since the optimal treatment of these neoformations is surgical, the study and knowledge of this area is essential for proper patient care. Methods: We present two cases of patients operated on for large tumors of the parapharyngeal space in the Otorhinolaryngology Department of the Hospital Clínico Universitario de Valladolid (HCUV) in the last 3 years using two different approaches (external approach and endoscopic endonasal approach). Results: The first patient is a 79-year-old man who underwent a right cervicotomy, excision of a parapharyngeal-cervical tumor and transoral excision (TOUSS) of a base of tongue tumor due to an acinar cell carcinoma located in the right parapharyngeal pre-stylar space. The second patient is a 42-year-old female patient operated by endoscopic nasosinusal surgery (transpterygoid approach of the infratemporal fossa) for a tumor occupying the left pterygopalatine and infratemporal fossae with a diagnosis of schwannoma. Discussion: External approaches have classically been the most widely used surgical approach, mainly because of their optimal exposure of the entire surgical field. Its main disadvantages are the great impact on tissue functionality, postoperative complications, surgical time and hospitalization time as in the case of the first patient, who required a 10-day hospitalization, two days of post-surgical orotracheal intubation, rehabilitation and complementary post-surgical treatment with radiotherapy. Endoscopic approaches avoid facial scarring and have more comfortable and less painful postoperative periods for patients, as in the case of the second patient, with a 3-day hospital stay. Their limited visibility, less control of the internal carotid artery (ICA) in case of injury, and the possibility of tumor spillage (pleomorphic adenoma) make endoscopic approaches of limited application at present. Conclusions: Tumors of the parapharyngeal space are a complex pathology and difficult to treat. Currently, complete surgical excision remains the treatment of choice. Because this anatomical area is particularly complex and presents a wide variety of relevant neurovascular structures, a thorough pre-surgical study of these structures is essential to avoid complications. [ABSTRACT FROM AUTHOR]

Introduction and objective: The parapharyngeal space is a deep craniocervical space where primary tumors are exceptional, constituting only 0.5% of all head and neck neoformations. Benign lesions represent 70-80%, with pleomorphic adenoma being the most frequent tumor in this location. The treatment of choice at present continues to be complete surgical resection of the lesion. Although classically the most commonly used surgical approach has been the external approach, nowadays, with the appearance of endoscopic techniques, new methods of approach useful for the resection of parapharyngeal tumors have been described. Methods: We present a systematic review of external, endonasal and transoral surgical approaches to the parapharyngeal space, with a total of 1725 patients and 92 (sides) of cadavers where the type of approach used/studied in each surgery was analyzed, comparing both the advantages and disadvantages offered by each of them. Results: The systematic review has a total of 40 articles, 1654 patients and 92 (sides) of cadavers where the type of approach used/studied in each surgery was analyzed. Discussion: External approaches have classically been the most used type of surgical approach. They present important advantages such as being the only type of approach with which the surgical field is completely exposed. The drawbacks include a great impact on the functionality of the tissues, a wide variety of postoperative complications and a longer surgical time and hospital admission time. Endoscopic approaches have had great development in recent years and present advantages such as being less damaging surgeries in terms of tissue functionality, avoiding facial scars or more comfortable and less painful post-operative treatments for the patient. But they also have drawbacks such as a lack of space or surgical scope of the technique and a limited application, which depends on both the size and type of tumor that the patient has. Conclusions: Although traditionally the most commonly used surgical approach has been the external approach, in recent decades and especially strikingly and relevantly in recent years, endoscopic surgery has been a revulsive when performing surgeries in this location. Both endonasal and transoral endoscopic approaches, with or without the use of robotic technology, have made it possible to operate on parapharyngeal lesions with less functional repercussions, a more comfortable and less painful postoperative period, and less prolonged hospitalization than with traditional techniques. [ABSTRACT FROM AUTHOR]

Renewal efforts in learning basic electricity and electronics in vocational high schools need to be carried out in order to find the right formula in learning as a new tool to improve students' higher-order thinking skills (HOTS). HOTS are in three dimensions of knowledge, namely conceptual, procedural, and metacognition, which intersect with cognitive levels C4 (analyse), C5 (evaluate), and C6 (create). This research is a quasi-experimental, nonequivalent control group design by applying Matlab application-based learning in the experimental class and comparing it with direct learning in the control class to see differences in students' higher-order thinking skills. In addition, it also looks at the interaction effect between the type of learning applied and the moderator variable, namely the thinking style of students (internal and external), on students' HOTS in three dimensions of knowledge (conceptual, procedural, and metacognition). The participants, or experimental subjects, in this study were class X students with audio-video engineering expertise (TAV). Class X TAV 1 was selected as the experimental class with 34 students, while class X TAV 2 became the control group with 32 students. The results obtained showed the effect of matrix-based learning better than direct learning on students' HOTS in the dimensions of conceptual knowledge, procedural knowledge, and metacognition, and there was no interaction between the type of learning applied and the students' thinking style. Matlab-based learning and thinking styles had a strong influence separately on students' HOTS in the three knowledge dimensions. [ABSTRACT FROM AUTHOR]

This study aimed to determine the structural relationship between internal and external egg quality (IEEQ) traits. In this study, 114 eggs produced from 24 weeks-old laying hens reared at the Ondokuz Mayis University Research Farm were used. Egg weight (EW), egg width (EWi), egg length (EL) and shell weight (SW) measurements were examined as external quality traits. Also, albumen height (AH), albumen width (AW), yolk height (YH), yolk weight (YW) and yolk diameter (YD) parameters were used as internal quality traits. Structural Equation Model (SEM) was used to determine the relationships between IEEQ traits. Data analysis was performed with the LISREL package. It has been determined that the variables that are important in determining the external egg quality are SW, EWi and EL. When the variables explaining the internal traits were examined, it was determined that the YW, YD, AW, AH and YH were significant. It was determined that the relationship between external egg quality and internal quality was 0.96 and external quality explained the internal quality by 91%. It has been determined that the SEM used in this study is sufficient to explain the relationship between internal and external quality.

The momentum of COVID-19 should be an opportunity for courier business owners because many people focus on their activities at home and rely on courier services to shop. Two big players such as JNE and JnT have shown an increase in transaction volume in 2020 and 2021. On the other hand, Pos Indonesia has experienced a 15% decrease in profit from usual. This phenomenon is also reflected in the scale of Postal Agents, one of the official partners of Pos Indonesia. Referring to data from the Central Post Office in Sidoarjo, the income of all Postal Agents in Sidoarjo decreased by around 15% during the pandemic, starting in 2020 Rp. 11.3 billion to Rp. 9.6 billion in 2021. This research was conducted to investigate the influence of aspects of external and internal factors on the performance of Postal Agents. All research data comes from questionnaires filled out by 30 respondents who are managers of Postal Agents in Sidoarjo. Then the data was analyzed using the SEM-PLS (Structural Equation Modeling Partial Least Square) method. The results showed that internal factors had a positive influence on the performance of Postal Agents with a T-statistic of 3.115 and a P-value of 0.002 (<0.05). From these internal factors, it is known that finance and service products are the most influential aspects. Meanwhile, external factors did not have a positive influence on the performance of Postal Agents with a T-statistic of 0.123 and a P-value of 0.902 (> 0.05). [ABSTRACT FROM AUTHOR]

Copyright of Oilfield Chemistry is the property of Sichuan University, Oilfield Chemistry Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To define and compare the effectiveness of external dacryocystorhinostomy (EX-DCR), endonasal (EN-DCR), and transcanalicular laser-assisted (TL-DCR) with or without silicone stent (S) intubation. Methods: Studies were retrieved from PubMed, Scopus, and WoS. Frequentist and Bayesian network meta-analyses were performed and pooled estimations were expressed as risk ratio (RR). We included all original investigations of prospective, randomized controlled trials comparing success rate for any two of the following six surgical procedures: standard EX-DCR with or without S, cold EN-DCR with or without S, and TL-DCR with or without S. The primary outcome measure was the objective success rate. Results: Thirty-two studies with 3277 cases were included in the final quantitative analysis. TL-DCR with S was inferior to EN-DCR with S (RR: 1.20; 95% CI: 1.05–1.37), EX-DCR with S (RR: 1.17 95% CI: 1.05–1.29), EN-DCR without S (RR: 1.18; 95% CI: 1.03–1.35), and EX-DCR without S (RR: 1.15; 95%CI: 1.05–1.26) in frequentist statistics. No other statistical difference was found between other surgeries. When we excluded studies with additional interventions (nasal and revision surgery) for sensitivity analysis, 23 studies with 2468 cases were included to analysis. The success rates of TL-DCR with S and EN-DCR without S became similar (RR: 1.14 95% CI: 0.99–1.30) but there was no change in other outcomes. Similar results were found in Bayesian statistics. The surface under the cumulative ranking curve was higher for EN-DCR with S (0.75), whereas it was higher for EX-DCR with S (0.56) after sensitivity analysis. Conclusion: Between endoscopic and external and transcanalicular laser without S procedures, there is no statistical difference. The rank probability showed that EN-DCR with S was a more appropriate surgical option when patients with nasal disease were included, whereas EX-DCR with S was a more appropriate surgical option when patients with nasal disease were excluded from the analysis. [ABSTRACT FROM AUTHOR]

This review investigated whether any therapeutic options influenced the outcome of treatment for teeth with external cervical resorption. Out of 870 articles identified by an electronic search, 60 clinical case reports and six case series were included. No randomised clinical trials were found. Risk of bias was assessed using Joanna Briggs Institute's tools. External surgical intervention was the preferred method of accessing the lesions. Removal of resorptive tissue was most often achieved mechanically. Bioactive endodontic cements were the preferred materials for restoring teeth. The outcome measures were based on clinical and radiographic parameters. Of the cases included in the review, no specific treatment approach had a superior outcome in relation to Heithersay's classification. Furthermore, due to the absence of randomised clinical trials, and the low level of evidence associated with case reports/case series, it was not possible to define the optimum clinical treatment for external cervical resorption. [ABSTRACT FROM AUTHOR]

Every activity or action carried out by humans must find various problems in it, including problems in the moral development of students in elementary schools. The purpose of this study was to find out how the problems of PAI teachers are in fostering morals in elementary school students. This study uses a qualitative method with a descriptive approach. researchers conducted research at SD Negeri 18 Padang City. Sources of data were taken through direct interviews with three informants. The informants consisted of school principals, PAI teachers and class teachers. The data collection techniques used are observation, interviews and documentation. All interview results were analyzed thematically using the Miles and Huberman technique. While testing the validity of the data using a credibility test with increased persistence and triangulation. The research findings found that the problems in fostering student morals in elementary schools came from external and internal factors. Problems that arise due to external factors are the family environment and social environment. Problems that arise due to internal factors are the lack of PAI teachers in teaching religious knowledge and instilling noble moral values in students. Not only that, there are still teachers who break the rules, such as arriving late and speaking in a high tone.

Primary temporal bone meningioma of the middle ear is relatively rare in clinical practice. It is difficult to distinguish it from otitis media with effusion or chronic otitis media owing to its similar clinical presentation. We report the case of a 73‑year‑old temporal bone meningioma extending to the middle ear as well as involving the external auditory canal. High‑resolution computed tomography revealed the possibility of left chronic otomastoiditis. After debulking and biopsy, it turned out to be an extracranial meningioma. [ABSTRACT FROM AUTHOR]

Context: Measuring isometric shoulder rotational strength is clinically important for evaluating motor disability in athletes with shoulder injuries. Recent evidence suggests that handheld dynamometry may provide a low-cost and portable method for the clinical assessment of isometric shoulder strength. Objective: To investigate the concurrent validity and the intrarater and interrater reliability of handheld dynamometry for measuring isometric shoulder rotational strength. Design: Cross-sectional study. Setting: Biomechanics laboratory. Participants: Thirty-nine young, healthy participants. Main Outcome Measures: The peak isometric strength of the internal rotators and external rotators, measured by handheld dynamometry (in newton) and isokinetic dynamometry (in newton meter). Interventions: Maximal isometric shoulder rotational strength was measured as participants lay supine with 90° shoulder abduction, neutral rotation, 90° elbow flexion, and forearm pronation. Measurements were performed independently by 2 different physiotherapists and in 3 different sessions to evaluate interrater and intrarater reliability. The data obtained by handheld dynamometry were compared with those obtained by isokinetic testing to evaluate concurrent validity. Results: The intraclass correlation coefficients for interrater reliability in measuring maximum isometric shoulder external and internal rotation strength were.914 (95% confidence interval [CI],.842–.954) and.842 (95% CI,.720–.914), respectively. The intrarater reliability values of the method for measuring maximal shoulder external and internal rotation strength were 0.865 (95% CI, 0.757–0.927) and 0.901 (95% CI, 0.820–0.947), respectively. The Pearson correlation coefficients between the handheld and isokinetic dynamometer measurements were.792 (95% CI,.575–.905) for external rotation strength and.664 (95% CI,.419–.839) for internal rotation strength. Conclusions: The handheld dynamometer showed good to excellent reliability and moderate to good validity in measuring maximum isometric shoulder rotational strength. Therefore, handheld dynamometry could be acceptable for health and sports professionals in field situations to evaluate maximum isometric shoulder rotational strength. [ABSTRACT FROM AUTHOR]

Key Clinical Message: This is the case of a 51‐year‐old woman with chronic progressive external ophthalmoplegia (CPEO) alongside some comorbidities in a low‐resource setting. This report seeks to sensitise clinicians about this rare condition in order to increase their index of suspicion and avoid misdiagnosis. [ABSTRACT FROM AUTHOR]

This study aims to explain the indicators of human resource productivity management in Kerman executive agencies. It is a descriptive, correlational as well as a developmental study purposefully conducted as a survey in the field of human resources. The sample includes 30 experts in the field of management and administration. It was obtained by purposeful sampling method and included 524 employees of the Kerman executive agencies that were gathered by stratified sampling method. Two questionnaires were used by the experts to confirm the validity and reliability of the model and one questionnaire was used to answer the questions. The validity and reliability of all questionnaires were confirmed. AMOS and SPSS statistical software were used for data analysis. The 42 subscales of human resource productivity management are summarized in 5 factors (individual, organizational, complementary organizational, occupational, and extra-organizational). It is an applieddevelopmental study considering the simultaneous identification of factors related to human resource productivity in line with the development indicators and can be used by all executive agencies throughout Iran. [ABSTRACT FROM AUTHOR]

CONCLUSION An extended external rhinoplasty approach for removal of nasal dermoid cysts with intracranial extension provides adequate cyst exposure, enables nasal bone osteotomies, and allows access to the skull base while achieving a cosmetically acceptable scar. The extension of the external rhinoplasty incision to the alar base and the rim achieves adequate mobilization of the nasal dorsal skin, which coupled with removal of the nasal bones, provides adequate access to the anterior skull base. Keywords: rhinoplasty; external; nasal dermoid; intracranial; pediatric; child; encephalocele EN rhinoplasty external nasal dermoid intracranial pediatric child encephalocele 2798 2802 5 09/21/23 20231001 NES 231001 We present an extended external rhinoplasty approach with bilateral marginal and alar base incisions for removal of a nasal dermoid cyst with intracranial extension in a 3-year-old patient. [Extracted from the article]

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AbstractThis paper documents the estimation of mean heights and body masses, by age and sex, used in development of organ-specific dose conversion coefficients for external radiation for a historical cohort of about 64,000 patients from the Canadian Fluoroscopy Cohort Study. Patients were exposed to repeated fluoroscopy and chest radiography examinations in the course of treatment for tuberculosis in residential medical facilities throughout Canada between 1930 and 1969. Using Canadian national survey data and extensive literature review, mean heights and masses were obtained for the White population of Canada during the time period of interest, and the differences in mean body mass between tuberculosis patients and the general population were estimated. Results in terms of mean height and body mass of Canadian tuberculosis patients, with uncertainties, are reported for selected age groups (children of ages 1, 5, 10, and 15 y and adults age 20+) and for both sexes. Use of estimated average heights and body masses by age and sex permits the adjustment of computerized phantoms for body mass for a given age, thereby increasing the relevance of the organ-specific dose conversion coefficients for the cohort and improving the accuracy of the resulting estimated organ doses.

A major obstacle for tissue engineering ear-shaped cartilage is poorly developed tissue comprising cell-scaffold constructs. To address this issue, bioresorbable scaffolds of poly-ε-caprolactone (PCL) and polyglycolic acid nanofibers (nanoPGA) were evaluated using an ethanol treatment step before auricular chondrocyte scaffold seeding, an approach considered to enhance scaffold hydrophilicity and cartilage regeneration. Auricular chondrocytes were isolated from canine ears and human surgical samples discarded during otoplasty, including microtia reconstruction. Canine chondrocytes were seeded onto PCL and nanoPGA sheets either with or without ethanol treatment to examine cellular adhesion in vitro. Human chondrocytes were seeded onto three-dimensional bioresorbable composite scaffolds (PCL with surface coverage of nanoPGA) either with or without ethanol treatment and then implanted into athymic mice for 10 and 20 weeks. On construct retrieval, scanning electron microscopy showed canine auricular chondrocytes seeded onto ethanol-treated scaffolds in vitro developed extended cell processes contacting scaffold surfaces, a result suggesting cell-scaffold adhesion and a favorable microenvironment compared to the same cells with limited processes over untreated scaffolds. Adhesion of canine chondrocytes was statistically significantly greater (p ≤ 0.05) for ethanol-treated compared to untreated scaffold sheets. After implantation for 10 weeks, constructs of human auricular chondrocytes seeded onto ethanol-treated scaffolds were covered with glossy cartilage while constructs consisting of the same cells seeded onto untreated scaffolds revealed sparse connective tissue and cartilage regeneration. Following 10 weeks of implantation, RT-qPCR analyses of chondrocytes grown on ethanol-treated scaffolds showed greater expression levels for several cartilage-related genes compared to cells developed on untreated scaffolds with statistically significantly increased SRY-box transcription factor 5 (SOX5) and decreased interleukin-1α (inflammation-related) expression levels (p ≤ 0.05). Ethanol treatment of scaffolds led to increased cartilage production for 20- compared to 10-week constructs. While hydrophilicity of scaffolds was not assessed directly in the present findings, a possible factor supporting the summary data is that hydrophilicity may be enhanced for ethanol-treated nanoPGA/PCL scaffolds, an effect leading to improvement of chondrocyte adhesion, the cellular microenvironment and cartilage regeneration in tissue-engineered auricle constructs.

Key Clinical Message This is the case of a 51‐year‐old woman with chronic progressive external ophthalmoplegia (CPEO) alongside some comorbidities in a low‐resource setting. This report seeks to sensitise clinicians about this rare condition in order to increase their index of suspicion and avoid misdiagnosis.

Gas metal arc additive manufacturing (GMA-AM) is gaining great attention to produce large-scale parts owing to its merits of low device investments and high deposition rates. Despite this fact, a robust control system for deposition height in thin-walled parts is yet to be developed due to the lack of an appropriate controlling variable. This study attempts to propose an external wire-based GMA-AM technique to solve this issue. The influences of arc current, travel speed, and external wire feed speed (EWFS) on layer geometry were studied. It is indicated that the EWFS exhibits a greater influence on the layer height of thin walls than the arc current and the travel speed. The nozzle to the top surface distance (NTSD), monitored via a vision sensor, was extracted by Median filter, Sobel algorithm, Canny algorithm, and Hough transform. The dynamics between the NTSD and the EWFS were established via a nonlinear model. A parameter self-tuning fuzzy controller was designed to control the NTSD via changing the EWFS. System simulation tests and control tests were performed to validate the robustness of the parameter self-tuning fuzzy controller. [ABSTRACT FROM AUTHOR]

External root resorption is a clinical problem that is difficult to diagnose, therefore radiographic examination is important for diagnose. The purpose of this study was comparing the diagnostic accuracy of 2 Cone Beam Computed Tomography in detecting of external root resorption, in vitro.Materials & Methods:This study was done on 48 single-rooted teeth. Cavities of 0.3, 0.2 and 0.15 mm in depth with round bur 0.3 mm were drilled on buccal and lingual surfaces in the cervical, middle and apical thirds of some of roots. Then CBCT were taken and 4 observers assessed the scans. Sensitivity, specificity and Kappa value were determined. The statistical analysis was performed with the Z-test (p value < 0.05).Results:In comparison of the accuracy, sensitivity and specificity of the two devices, there was no significant difference. In the apical, middle and cervical as well as at various depths there was no significant difference between the two devices, but in the numerical point of view, the sensitivity for both devices in the midsection, was in the highest amount. The highest value for the specificity is related to the apical region. For both devices, the sensitivity level GBJ, by increasing the depth. The lowest agreement between observers was 0.61. The highest agreement rate was in the middle section and the least amount of agreement was related to the apical region.Conclusion:CBCT brand type is not effective factor in the detection of external root resorption. The location and depth of external root resorption can be effective factors in diagnostic accuracy

Like the other genre of Urdu, the pride of fiction writing is with male writers, but female writers have also added a lot to it. Among them names of Khaton Akram, Mrs Abdul Qadir, Abbasi Begam, Khadija Mastoor, Hajra Masroor and Qurat ul Ain Haider are very important. Praimchand was the first fiction writer who started fiction writing in a realistic manner. Realistic fiction writers kept themselves attached to internal and external aspects of life, specially the female fiction writers of 20th century, did apprecial work in the field. Realistic writing of every period has a different trend. Inspite of passing centuries of time importance of realistic fiction writing cannot be ignored. Realistic writing in Urdu is a living and popular trend of fiction writing.